Summary of CDC consultations related to nontraditional therapies and settings, 2016–2023

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Abstract
Objective and Design: Therapies provided in nontraditional settings or by individuals without knowledge of core principles of infection prevention and control (IPC) may place consumers at risk of adverse events. We summarize findings from our recent consultation experiences in the Division of Healthcare Quality Promotion (DHQP) at the Centers for Disease Control and Prevention (CDC) to help identify targets for prevention efforts and enhanced consumer protections. Methods: We reviewed records of DHQP consultations with state, local, or territorial health officials conducted from 2016 to 2023 to identify investigations involving nontraditional therapies or settings in the United States. Information collected included type of procedure or therapy, type of setting, pathogens involved, number of affected individuals, and types of IPC issues identified. Results: Of 1500 consultations, we identified 30 (2%) involving nontraditional therapies or settings. Therapies were performed for esthetic reasons, general wellness, or as treatment for pain. Infectious pathogens were identified in the blood, joint fluid, and skin and soft tissue, and included viruses, bacteria, and fungi. Investigations revealed breaches in injection safety, medical device reprocessing, medication preparation and handling, and environmental disinfection. Over 7000 consumers received notification regarding potential exposure to an infectious pathogen. Conclusions: This summary highlights the potential infectious risks to consumers posed by nontraditional therapies, which may have unproven benefits and poorly defined risks. With continued expansion of nontraditional therapies and settings, consumers will benefit from education, training, and oversight of those who provide therapies in these settings.

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